The Correlation Between Thromboelastpgram Combined With Laboratory Results And The Severity Of Coronary Artery Lesions Of Patients With Coronary Heart Disease

Background: Atherosclerotic coronary heart disease is still a major disease that threatening human health,causing disability and death.Plaque rupture and thrombosis are the pathological basis of acute vascular events,such as myocardial infarction.The complex interactions between platelets,vascular endothelial cells,inflammatory cells,and circulating proteins leads to plaque rupture,platelet activation and aggregation,and thrombus formation,which eventually result in acute clinical events.Thromboelastogram is widely used to monitoring the function of platelets and coagulation,predicting of bleeding and ischemic events in clinic and guiding the usage of antithrombotic drugs.There is few research on the correlation between thromboelastogram and the severity of coronary artery lesions.Immunocyte and cytokines have been shown to play an important role in the inflammatory immune injury mechanism of coronary heart disease,with limiting clinical application of cardiovascular disease.Gensini score is now widely used to quantify the severity of coronary artery disease.The purpose of this study is to explore the correlation between thromboelastogram combined with laboratory results and the severity of coronary artery disease,and to establish a forecasting model for coronary artery disease.Methods: 584 patients from 2019-02-01 to 2019-08-01 in Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine with percutaneous coronary intervention were included continuously.They were divided into research group and the validation group according to the enrollment order.Details of history,clinical test and the result of percutaneous coronary intervention were recorded and analyzed.Results: Gensini score was significantly correlated with platelet function and clopidogrel inhibition rate(p<0.01).IL-6,INF-γ,and IL-17 A were significantly correlated with Gensini score in patients with coronary heart disease(p<0.05).With the inclusion of coronary heart disease risk factors,multiple linear regression analysis suggested that clopidogrel inhibition rate(p<0.05)and IL-17A(p<0.01)were still significantly and independently correlated with the severity of coronary artery disease.In addition,creatinine(p<0.01),smoking history(p<0.01),heart rate(p<0.01),and cholesterol(p<0.01)were independently correlated with Gensini score.A forecasting model was established,suggesting that in validation group the prediction results of the model were correlated with Gensini score(p<0.05).Conclusion: The clopidogrel inhibition rate,IL-17 A,creatinine,smoking history,heart rate,and cholesterol were significantly and independently correlated with the severity of coronary artery lesions in coronary heart disease patients undergoing percutaneous coronary intervention.The forecasting model established with the indexes above is able to predict the severity of coronary artery lesions and evaluate the prognosis of patients and guide the application of drugs,which has great clinical significance.